eClinicalWorks EHR Users Blog

Tutorials, Tips, and Updates for eClinicalWorks EHR Users

Providers across the United States are participating in the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting System (PQRS) program. PQRS is a reporting program that uses incentive payments and payment adjustments to promote reporting of quality information. Incentive payments for PQRS continue through the 2014 program year, and payment adjustments begin in 2015, and are based on 2013 reporting.

WESTBOROUGH, Mass., Aug 05, 2013 (BUSINESS WIRE) -- eClinicalWorks announced today that the eClinicalWorks V10 system is compliant with the ONC 2014 Edition criteria and was certified as a Complete EHR on July 24, 2013 by the Certification Commission for Health Information Technology (CCHIT(R)), an ONC-ACB, in accordance with the applicable Eligible Provider certification criteria adopted by the Secretary of Health and Human Services. The ONC 2014 Edition criteria support both Stage 1 and 2 meaningful use measures required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA).

Medicare EPs: How to Avoid Payment Adjustments

Medicare eligible professionals (EPs) who do not demonstrate meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program may be subject to payment adjustments beginning onJanuary 1, 2015. Because payment adjustments are mandated to begin on the first day of the 2015 calendar year, CMS will determine the payment adjustments based on meaningful use data submitted prior to the 2015 calendar year.

Medicare Claims processing, Sequestration and 2% Cut

As you know, on March 1st, President Obama issued a sequestration order as required by the Budget Control Act of 2011. Although for most federal programs the effects of sequestration began immediately, for Medicare Part A and Part B, the sequestration related cuts do not take effect until April 1st.

Medicare and Medicaid electronic health record payments are estimated to have blasted through $10.3 billion to a total of 180,200 physicians and hospitals through December since the program's inception. December's payments of $1.25 billion were driven by the largest amount of hospital payments for an individual month, according to Robert Anthony, a specialist in CMS' Office of eHealth Standards and Services.

The Stage 2 rule for the Electronic Health Record (EHR) Incentive Programs included changes to the Stage 1 meaningful use objectives, measures, and exclusions for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs). Some of these Stage 1 changes took effect on October 1, 2012, for eligible hospitals and CAHs, or January 1, 2013, for EPs. Several are optional, but others are required.

The House of Representatives late Tuesday approved the Senate's last-minute fiscal cliff package (PDF) that staves off a sharp Medicare physician pay cut by cutting billions from other Medicare providers, including hospitals, pharmacies and dialysis clinics.

Early on New Year's Day, the Senate voted 89-8 to approve the American Taxpayer Relief Act, an amended version of a tax bill that House Ways and Means Chairman Dave Camp (R-Mich.) introduced last summer. House members on Tuesday considered the Senate-passed legislation in meetings during the day and floor debate in the evening. In a vote of 257 to 167, the House passed the measure, which permanently extends middle-class tax cuts and postpones the automatic spending cuts known as the sequester for two months. The legislation also averts the expected 26.5% Medicare physician payment cut and extends current Medicare payment rates for doctors through Dec.31, 2013.

Now that both chambers have approved the package, Congress will send the legislation to President Barack Obama for his signature. Moments after the House vote, the president said in a brief news conference that Tuesday's agreement helps reduce the nation's deficit by raising $620 billion in revenue from the wealthiest households in America. He also noted there will be more deficit reduction as Congress considers how to address the sequester, and he indicated he's open to reforms in the Medicare program.

“As I've demonstrated throughout the past several weeks, I am very open to compromise. I agree with Democrats and Republicans that the aging population and the rising cost of healthcare makes Medicare the biggest contributor to our deficit," the president said. "I believe we've got to find ways to reform that program without hurting seniors who count on it to survive. And I believe that there is further unnecessary spending in government that we can eliminate. But we can't simply cut our way to prosperity."

A proposed federal rule nips and tucks previously issued regulations governing the testing, certification and use of electronic health-record systems.

The proposed rule, issued jointly by the CMS and the Office of the National Coordinator for Health Information Technology, tweaks several of the meaningful-use criteria that healthcare providers must meet to qualify for payment under the federal EHR incentive program.

For example, it adds an alternative meaningful-use criterion for the electronic transmission of structured lab results from hospitals to ambulatory-care providers who ordered the lab test.

The CMS issued a final rule late Thursday temporarily increasing primary care physician payments from Medicaid.

The rule (PDF), which implements a provision of the Patient Protection and Affordable Care Act, details the extent and target of the increase, which takes effect in January and lasts through 2014.

The provision is designed to match Medicare rates, but the rule specifically covers only the difference between the Medicare rate and states' Medicaid rates as of July 1, 2009. The additional federal funding may not be enough to increase the rate to Medicare levels because some states have enacted Medicare provider rate cuts since mid-2009.

The Office for Civil Rights appears to be sending a stern and serious message to practices nationwide as the first stage of Meaningful Use wraps up. Less than four months after the Alaska DHHS’s $1.7 million settlement we reported on in August, another practice has been slammed with a $1.5 million fine for a potential breach of the Health Insurance Portability and Accountability Act.

Read CMS' Press Release and Fact Sheet to Learn More about the Stage 2 Final Rule

Today, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that the Centers for Medicare & Medicaid Services (CMS) published the final rule for Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The rule provides new criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to successfully participate in the EHR Incentive Programs.

“The changes we’re announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care,” Secretary Sebelius said.

Nearly $4.5 billion in federal incentives to implement electronic health record systems has been paid out thus far, with program enrollments and payments still increasing in the first quarter of 2012, according to an analysis of the CMS' latest data (PDF).

There are now more than a quarter of a million (225,765) actively enrolled participants in the Medicare and Medicaid EHR incentive programs created under the American Recovery and Reinvestment Act of 2009, according to the CMS. Hospitals can receive payments under both the Medicare and the Medicaid programs, and most do, but physicians and other professionals can participate only in one program or the other.

Denial for Advanced Diagnostic Imaging Services

CMS has received reports that providers are receiving denials for advanced diagnostic imaging (ADI) services they are accredited to perform. We have taken action to correct the situation. CMS has instructed all contractors to review each ADI claim denial, and reprocess those claims that were deemed to be incorrectly denied, in a timely manner. Providers do not need to take any action in this situation.

Health and Human Services Secretary Kathleen Sebelius said that 2,000 hospitals and 41,000 physicians have received $3.1 billion in incentive payments for the meaningful use of certified electronic health records (EHRs).